Facial soft tissue thicknesses (FSTT) measurements collected from Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) imaging techniques are most commonly taken in the supine position for forensic craniofacial reconstruction. FSTT have been shown to be different in comparison to the upright position due to gravity. The variation of facial morphology between the upright and supine position of laser-scanned images taken from 44 individuals was investigated using volumetric analysis with deviation maps. Between 82.4% and 86.7% of the facial surface area were within the error range of ±2mm between the supine and the upright position. This indicates that most anatomical landmarks taken from the MRI and CT data can be an accurate representative of the FSTT in the upright position. Seven landmarks located around the buccal region, masseteric region and the nasolabial region of the face showed the greatest FSTT deviation between the upright and supine position, thus these landmarks may affect the accuracy of facial reconstructions when using a CT or MRI database.
Objective:The present study was designed to determine the effects of tirofiban (Tiro) infusion on angiographic measures, ST-segment resolution, and clinical outcomes in patients with STEMI undergoing PCI. Glycoprotein (GP) IIb/IIIa inhibitors are beneficial in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI), while the most effective timing of administration is still under investigation.Methods:A total of 1242 patients (83.0% males, mean (standard deviation; SD) age: 54.7 (10.9) years) with STEMI who underwent primary PCI were included in this retrospective non-randomized study in four groups, composed of no tirofiban infusion [Tiro (-); n=248], tirofiban infusion before PCI (pre-Tiro; n=720), tirofiban infusion during PCI (peri-Tiro; n=50), and tirofiban infusion after PCI (post-Tiro; n=224). In all Tiro (+) patients, bolus administration of Tiro (10 pg/kg) was followed by infusion (0.15 pg/kg/min) for a mean (SD) duration of 22.4±6.8 hours.Results:The pre-PCI Tiro group was associated with the highest percentage of patients with TIMI 3 flow (99.4%; p<0.001), the lowest corrected TIMI frame count [21(18-23.4); p<0.001], the highest percentage of patients with >75% ST-segment resolution (78.1%; p<0.001), and the lowest rate of in-hospital sudden cardiac death and in-hospital all-cause mortality (3.2%, p<0.05, 3.3%, p=0.01). Major bleeding was reported in 18 (1.8%) patients who received tirofiban.Conclusion:Use of standard-dose bolus tirofiban in addition to aspirin, high-dose clopidogrel, and unfractionated heparin prior to primary PCI significantly improves myocardial reperfusion, ST-segment resolution, in-hospital mortality rate, and in-hospital sudden cardiac death in patients with STEMI with no increased risk of major bleeding.
Acute renal infarction due to emboli represents a very rare but significant threat for kidney loss, and the clinical presentation is challenging. The differential diagnosis of massive renal thrombi includes all other causes of abdominal pain, and they can be easily misdiagnosed as renal colic due to nephrolithiasis. Although there are a few case reports regarding the possibility that cardiac emboli may cause acute kidney infarction, intracardiac thrombi within the ventricular cavity diagnosed by echocardiography as a cause of such renal artery occlusion have never been reported in patients with cardiomyopathy. Herein, we describe a 39-year-old male with a history of ischemic dilated cardiomyopathy. He was admitted to our hospital with left upper abdominal pain and vomiting. After serial examinations and tests, the diagnosis of acute renal infarction due to intracardiac thrombus embolization as a result of severely reduced cardiac function was made.
Double-orifice mitral valve (DOMV) is a rare congenital malformation characterized by two separate valve orifices of varying sizes in association with the abnormalities of the subvalvular apparatus. It has been reported to be associated with a variety of other congenital malformations. We report a rare case of incomplete form of Shone's complex composed of a complete bridge-type DOMV and bicuspid aortic valve, well demonstrated by both transthoracic and transoesophageal echocardiography and cardiac magnetic resonance imaging.
ÖZETAmaç: Nötrofil jelatinaz-birleşik lipokalin (NJBL) renotübüler kötüye gidişatın erken tespitinde kullanılan yeni bir belirteçtir. Kalp yetersizliğinde (KY) NJBL'ye dair sınırlı veri bulunmasına rağmen sağ KY'deki önemi bilinmemektedir. Biz serum ve idrar NJBL seviyelerini sol ve sağ kalp yetersizliğinde-non-iskemik kardiyomiyopati (NİKMP) ve ciddi pulmoner arteryel hipertansiyonda (PAH) araştırdık. Yöntemler: Enine-kesitli gözlemsel olan bu çalışmada 3 grubu karşılaştırdık; NİKMP'li 35 hasta, PAH'lu 28 hasta ve 27 sağlıklı kontrol grubu. Hiçbirinin serum kreatinini ≥1.5 mg/dL değil idi. Plazma beyin natriüretik peptid (BNP) seviyeleri, Cockroft-Gault ve Modification of Diet in Renal Disease Study formülleri ile hesaplanan tahmini glomerüler filtrasyon hızı (tGFH), sağ ve sol ventrikül ekokardiyografik ölçümleri ve kardiyak indeksin (Kİ) eko ve impedans kardiyografi ile non-invaziv ölçümleri değerlendirildi. Devamlı değişkenlerin gruplar arası karşılaştırılması ANOVA ve Kruskal-Wallis testi ile yapıldı. Devamlı olmayan değişkenler ise Ki-kare testi ile değerlendirildi. Bulgular: Cockroft-Gault formülü ile hesaplanan tGFH, NİKMP ve PAH alt gruplarında kontrol grubuna kıyasla daha düşük olmasına rağmen (102±27 ve 99.4±29.4'e karşı 122.4±25.9 mL/dak, p<0.05 ve p<0.005 sırası ile), serum [174][175][176][177][178][179][180][181][182][183][184][185][186][187][188][189][190][191][192]
ABSTRACTObjective: Neutrophil gelatinase-associated lipocalin (NGAL) is a novel marker for early detection of renotubular deterioration. Despite the limited data concerning the NGAL in heart failure (HF), significance of NGAL in right-sided HF remains unknown. We assessed serum and urinary NGAL in left and right-sided HF due to non-ischemic cardiomyopathy (NICMP) and severe pulmonary arterial hypertension (PAH). Methods: In this cross-sectional observational study, we compared three groups; 35 patients with NICMP, 28 patients with PAH and 27 healthy controls. None had a serum creatinine ≥1.5 mg/dL. Plasma brain natriuretic peptide (BNP) levels, estimated glomerular filtration rate (eGFR) by Cockroft-Gault (CG) and Modification of Diet in Renal Disease Study formulas, echocardiographic measures of left and right ventricles (LV, RV) and non-invasive measurement of cardiac index (CI) by echocardiography and impedance cardiography were assessed. Differences among the groups for continuous variables were evaluated by the ANOVA and the Kruskal-Wallis test as appropriate. The Chi-square test was used for comparison of categorical variables. Results: Despite eGFR with CG formula was lower in NICMP and PAH subsets as compared to those in controls (102±27 and 99.4±29.4 vs 122.4±25.9 mL/min, p<0.05 and p<0.005 in order), serum [174][175][176][177][178][179][180][181][182][183][184][185][186][187][188][189][190][191][192] and 132 (95-181) ng/mL] and urinary [15][16][17][18][19][20][21][22] and 13 (8-18) ng/mL] levels were not different among groups (p=0.15 and p=0.35, respectively). Conclusion: Despite the mildly impaired eGFR in left-sided HF d...
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